Demystifying IYCF assessments Extrapolation of education learning initiative A CrossSectional study of HOSHIARPUR PUNJAB Block Dr Smriti Pahwa Abhinav Motheram Remy Hans ID: 613018
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RAPID DIET ASSESSMENT TOOL: Demystifying IYCF assessments- Extrapolation of education/ learning initiative
A Cross-Sectional study of HOSHIARPUR (PUNJAB) Block
Dr.
Smriti
Pahwa
,
Abhinav
Motheram
, Remy Hans,
Prabhsimran
,
Vajinder
Thakur
,
Sakshi
DudejaSlide2
Pratham
Education Foundation
Pratham Education foundation was established in 1995 in Mumbai and has grown in both scope and geographical coverage since then. India’s largest non government organization.
An innovative learning organization created to improve the quality of education. Run various programs reaching 7.7 million children across the country*.*http://www.pratham.org/Slide3Slide4
ASER (Annual Survey of Education Report)
ASER Centre was established in 2005.
The largest non-governmental household survey conducted in rural India. ASER surveys have been involving more than 25,000 volunteers and covering over 700,000 children in 15,000 villages each year. Tracks children’s ability to read and do basic arithmetic involving local organizations and institutions in every rural district in the country.
Has become an important resource for the education policies of both Central and State governments.Slide5
ASER Testing tool for ArithmeticSlide6
ASER Testing tool for LanguageSlide7
IYCF: FEW FACTS
Sound Infant and young Child Feeding (IYCF) practices are known to improve child’s growth, survival and intellectual development.
There is a policy push in India to unpack age appropriate complementary feeding so that the same can be better understood and adopted at community level.
An innovation was hatched extrapolating ASER/Pratham approach for large scale assessment and community participation approach in education for assessing IYCF and other domains involving National Service Scheme (NSS) students. Slide8
K.E.Y (Knowing and Engaging for Young child food and feeding)
An ECD-Nutrition curriculum to train frontline workers/volunteers to work with caregivers of very young children (less than 3 years) on nutrition, health and overall development.
Simple, measurable and actionable indicators have been identified to enable volunteers and caregivers to monitor Young child food and feeding practices, growth and overall health and development.Slide9
ECD Nutrition curriculum comprises of: Main K.E.Y module
Supporting modules- Growth monitoring, Immunization, Diarrhoea, Water, hygiene and sanitationSlide10
Rapid Diet Assessment tool: A rapid diet assessment tool was developed. An attempt to involve common people/ with not necessary technical background to unpack the age appropriate complementary feeding. A possible interface for common people to look at IYCF, analyze and assess gaps for possible action
Reference period: 24 hour
Rapid diet assessment tool developed
Based on ASER philosophy of community involvement, simple assessment and understandable evidenceSlide11
Rapid diet assessment toolSlide12
Rapid diet assessment toolSlide13
Rapid diet assessment toolSlide14
Training Process:
60 NSS students got Training on KEY in a workshop mode. First two days, information was given to them to build their capacities on allied topics followed by field exposure
To understand field realities, students got involved in doing the survey in 40 villages of Hoshiarpur Block.
Simple Rapid Diet assessment tool and a questionnaire was used to gauge information in order to understand the local perceptions, existing knowledge and practices in the community. Desk check of all the forms was done.Slide15
METHODOLOGY:
40 villages were randomly sampled of Hoshiarpur II block using probability proportional to size (PPS) sampling technique.
Villages selected were as per the Census 2011 village list. List of less than 2 year old children was obtained from Anganwadi centres.
16 households were covered from each village in order to give us a total targeted sample of 640 households to create a block report card of Hoshiarpur block.Slide16
FINDINGS: Slide17Slide18
Educational QualificationSlide19
Employment StatusSlide20Slide21
Infant and Young Child Feeding PracticesSlide22
Age
Exclusive breastfeeding
Other than Mother milk
n
%
n
%
<=6
(
N=139)
108
77.1
31
22.3
Distribution of children according to exclusive breastfeeding and other than mother milk (<= 6 months)Slide23
Age
Exclusive
breastfeeding
Other than Mother milk
n
%
n
%
7 – 8 months (N=71)
19
26.8
52
73.2
9 – 11 months (N=100)
16
16.0
84
84.0
>= 12 months (N=290)
13
4.5
277
95.5
Total (
N=461)
48
33.8
413
89.6
Distribution of children according to exclusive breastfeeding and other than mother milk (6 months above)Slide24Slide25
Category
Guidelines
Meeting guidelinesNot meeting
guidelines
Total
%
T
otal
%
7 – 8 months (N=71)
>=3 feeds
52
73.2
19
26.8
9 – 11 months (N=100)
>=4 feeds
81
81.0
19
19.0
>= 12 months (N=290)
>=4 feeds
260
89.7
30
10.3
Total (N=461)
393
85.2
68
14.8
Number of time additional feed was given according to the adherence to the guidelines Slide26Slide27
Dietary DiversificationSlide28
>
6 Month Child (Meal items consistency)
Consistency
No of meal
%Thick 172
6.3
Thin
1063
38.9
Medium
485
17.7
S
olid
1016
37.1
Total
2736
100.0
Meal consistency for children above 6 monthsSlide29
Measures taken to improve energy density of >6 month child meal
7-8 months
9-11 months
>=12 monthsTotal%Added Ghee
12
31
120
163
35.3
Added Jaggery
0
0
0
0
0
Use of ARF
0
0
0
0
0
A
ny
other
0
0
0
0
0
Total
163
Slide30
Measures taken to improve nutritional quality of food
7-8 months
9-11 months>=12 months
Total%Cooked in Iron utensils
17
42
191
250
54.2
Used lemon juice for better iron absorption
1
0
3
4
0.8
Germinated grains
0
0
0
0
0.0
Fermented the foods
0
0
0
0
0.0
Any other
0
0
0
0
0.0
No such measure taken
0
0
0
0
0.0Slide31
Other DomainsSlide32
If yes, why do you think regular weighing of children is
important?
n%It helps in weight gain of the child
12821.2
To monitor child's growth
395
65.4
Doctor has asked to do so
22
3.6
Any other
14
2.3
Don't know
39
6.5
Not
responded
6
1.0
GROWTH MONITORING
Do you have the growth chart of your child?
n
%
Yes
460
76.2
No
140
23.2
Not
responded
4
0.7
Total
604
According to you, how often should a child be weighed?
n
%
Every month
324
53.6
Once every three months
54
8.9
No specific time
64
10.6
At the time of immunization
83
13.7
Any other
16
2.6
Don't know
55
9.1
Not
responded
8
1.3Slide33
Do you think regular weighing of a child is important
n
%Yes552
91.4No51
8.4
Not
responded
1
0.2
If the weight was not measured, what is the reason? (n=338)
n
%
AWW was not present
17
5.0
Weighing machine was not available at AWC
13
3.8
Lack of information about child's weighing
93
27.5
Lack of time
158
46.7
Any other
40
11.8
Not
responded
17
5.0
Total
338
Slide34
Practice
Have you got your child weighed this month?
n%
Yes26443.7
No
338
56.0
Not
responded
2
0.3
Total
604
Slide35
When your child had Diarrhea last, what did you do ?
n
%Gave ORS46
22,4Gave home made sugar and salt solution8
3,9
Gave home made fluids
9
4,3
Took child to trained health worker
105
51,2
Mother's milk
14
6,8
Any other
23
11,2
Total
205
When child has diarrhoea, should there be any changes in the food and drink intake pattern of the child?
n
%
Increased food intake
27
4,5
Increased fluid intake
49
8,1
Did not change anything
114
18,9
Stopped feeding mother's milk
5
0,8
Decreased food and fluid intake
42
7,0
Not
Responded
367
60,8
Total
604
DiarrhoeaSlide36
Do you know how to prepare ORS solution?
n
%Explained Fully46
7.6Explained partially364
60.3
Don't know
169
28.0
Not
Responded
21
4.1
Total
600
Slide37
Do you think immunization is important
n
%Yes598
99.0No5
0.8
Not
responded
1
0,2
If yes, why is immunization important?
n
%
Protect from diseases
572
94.7
Everybody says so
8
1.3
Family members asked to
7
1.2
AWW told so
18
3.0
Neighbours do it
0
0.0
Don't know
9
1.5
Any other
3
0.5
IMMUNISATIONSlide38
Do you have your child's immunization card?
n
%Yes 554
91.7No48
7.9
Not
Responded
2
0.3
Total
604
If yes, vaccination
status (for children >=
12 months)
n
%
Total
immunization (n=290)
229
79.0Slide39
CONCLUSION:
Majority of the households have access to facilities but they have very little knowledge about right practices that need to be followed for development of a child
. It seems to be not so much of a problem of access but a problem of awareness.
we should be emphasizing more on making stakeholders than making beneficiaries.Easy assessments instruments like the one used here might have a potential to demystify young child food and feeding by involving ordinary people in assessments and understanding the gaps to propel action. Slide40
Acknowledgements
Rayat Bahra Institute of Management,
Hoshiarpur
Vajinder, Punjab state head, Pratham Pujab TeamCapacity Building Unit, ASER CentreSlide41
THANK YOU!Slide42
Energy Giving
Body Building
Protective Foods
Cereals & Millets
Roots & Tubers
Sugars
Fats & Oils
Nuts
Energy Giving
Pulses
Milk from animals
Milk in tea
Milk & Milk products
Egg
Meat
Body Building
Mother's milk
Green leafy vegetables
Dark colored fruits
Other vegetables
Citrus fruits
Dark colored fruits
Other fruits
Protective food
7-8 months (N=71)
71
42
8
23
1
33
51
12
35
4
13
0
0
47
59
0
3
14
2
0
3
17
%
59,2
11,3
32,4
1,4
46,5
71,8
16,9
49,3
5,6
18,3
0,0
0,0
66,2
83,1
0,0
4,2
19,7
2,8
0,0
4,2
23,9
9-11 months (N=100)
100
69
15
53
0
50
81
39
57
7
26
0
1
72
78
1
34
45
2
3
15
56 %69,015,053,00,050,081,039,057,07,026,00,01,072,078,01,034,045,02,03,015,056,0 >= 12 months (N=290)2902628422512022751311944412920263168813919571641215 %90,329,077,60,369,794,845,266,915,244,50,70,090,757,92,847,967,22,45,514,174,1 Total (N=461)461373107301228540718228655168213823059176254111959288 %80,923,265,30,461,888,339,562,011,936,40,40,282,966,22,038,255,12,44,112,862,5
No. of children given different food groupsSlide43
Measures taken to improve energy density of >6 month child meal
7-8 months
9-11 months>=12 months
Total%Added Ghee
12
31
120
163
35,3
Added Jaggery
0
0
0
0
0,0
Use of ARF
0
0
0
0
0,0
A
ny
other
0
0
0
0
0,0
Nothing
0
0
0
0
0,0
Total
163